Care of Clients With Gastrointestinal Disorders Copy 1
Care of Clients With Gastrointestinal Disorders Copy 1
Care of Clients With Gastrointestinal Disorders Copy 1
Diagnostic Test
Laboratory Tests
Radiographic Tests
Endoscopy
1. UGI Endoscopy
2. LGI Endoscopy
3. Colonoscopy
Gastrointestinal Interventions
Gastrointestinal Intubation
Purposes of NGT Insertion
1. Feeding
2. Irrigate stomach
3. Decompression
4. Medication administration
5. Administration of supplemental fluids
- Constipation/ Diarrhea
- Hyperglycemia
- Abdominal distention
- Vomiting
- Aspiration
1. Verify order
2. Assist on Fowler’s position
3. Insert feeding tube into the ostomy opening 10-15 cm
4. Check the patency
5. Check the residual feeding
6. Administer feeding slowly
7. Flush the tube with 30 ml of water
8. Keep the client in Fowler’s position for at least 30 minutes
9. Assess status of peristomal skin
10. Document
Administering TPN
1. Indications:
- Major GI diseases
- Severe trauma or burns
- Severe GI side effects
- Severe malnutrition
- Need extensive support
2. Usual site: Subclavian vein
3. Position: Trendelenburg during insertion
4. Primary purpose: administer glucose
5. Administer TPN at room temperature
6. Consume prepared formula within 24 hours
7. Maintain a steady infusion rate
8. Monitor urine and blood glucose levels
9. Care of catheter insertion site
10. Provide good oral hygiene
Administering Enema
1. Purposes:
- Relieve constipation
- Relieve flatulence
- Administer medication
- Lower body temperature
- Evacuate feces in preparation for diagnostic procedure or surgery
2. Types of Enema
- Cleansing Enema- stimulates peristalsis by irrigating the colon and rectum.
● High Enema
● Low Enema
- Carminative Enema- expel flatus
- Return Flow Enema/ Harris Flush/ Colonic Irrigation- used to expel flatus. Replace the
solution several times during the procedure as it becomes thick with feces
- Retention Enema- acts to soften the feces and to lubricate the rectum, anal canal, and
facilitate passage of feces
● Solution: Oil (90-120 ml)
● Height: 12 inches
● Temperature: 105-110-degree Fahrenheit
● Time of retention: 1-3 hours
- Non-Retention Enema- soften the feces and facilitate passage of feces
● Solution: Water/ Soap suds/ NSS/ Fleet enema
● Height: 18 inches
● Temperature: 115-125-degree Fahrenheit
● Time of retention: 5 to 10 minutes
3. Nursing Intervention
- Check doctor’s order
- Provide privacy
- Promote relaxation
- Position depends on the age
- Allow solution to flow through the connecting tubing and rectal tube to expel air
- Insert 7 to 10 cm of the rectal tube gently
- Introduce solution slowly
- Change the position to distribute solution well in the colon
- If cleansing enema: give the enema 3x
- Alternate hypotonic solution with isotonic solution
- If abdominal cramps occur stop temporarily
- After introduction of the solution, press the buttocks together to inhibit the urge to defecate
- Ask the client to not flush the toilet
- Do perineal care
- Document
4. Siphoning an Enema
- Solution: Water at 105-degree Fahrenheit
- Position: Right side lying position
- Height: 10 cm
- Quickly lower enema container after introduction of solution
- Document